Wish for euthanasia persists for at least one year after the request was declined by Euthanasia Expertise Center.

ABSTRACT

BACKGROUND: Euthanasia Expertise Center (EEC) in the Netherlands provides euthanasia or physician-assisted suicide for patients who meet all requirements of the Dutch Euthanasia Law, but whose treating physician declined their request. Little is known about how life continues for a patient after a request for physician-assisted death (PAD) is also declined by EEC. OBJECTIVE: To follow-up patients whose request for PAD was declined at EEC. METHODS: Between December 2016 and January 2020, 66 patients were prospectively followed for one year after their request was declined. Their general well-being and health, persistence of the wish for PAD, and mortality was measured by means of a questionnaire administered after three, six and 12 months. Furthermore, information was extracted from the patient's medical record. FINDINGS: More than half (58%) of the included patients suffered from an accumulation of old-age complaints. In the year after the request was declined, 15 patients (23%) died, three of whom committed suicide. Almost all patients who were alive after one year, persisted in their wish for PAD. Moreover, they were often not doing well. CONCLUSIONS: Considering that EEC is a last resort for those who were not granted PAD elsewhere, and that the wish for PAD persists, aftercare services should be provided to people whose request has been declined.